Organization
WEST GEORGIA MEDICAL CENTER, INC.
Active
Other names
Twin Fountains Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY J BUDZINSKI (EVP)
(470) 644-0012
Entity
Organization
Contact information
Practice address
1400 HOGANSVILLE RD, LAGRANGE, GA 30241-1422
(706) 882-0121
(706) 882-0123
Mailing address
1800 PARKWAY PL SE STE 500, MARIETTA, GA 30067-8237
(470) 956-4981
(770) 999-8237
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00142843A
—
GA
Enumeration date
09/03/2009
Last updated
02/24/2020
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